针刺联合西药治疗寒凝血瘀型子宫内膜异位症的临床疗效观察  

Clinical Efficacy Observation of Acupuncture Combined with Western Medicine in the Treatment of Endometriosis of Cold Accumulation Causing Blood Stasis Type

作　　者：祝子迎 吴慧颖 张萍[1] 杨丽娟[2] ZHU Zi-Ying;WU Hui-Ying;ZHANG Ping;YANG Li-Juan(Jiangxi University of Chinese Medicine,Nanchang 330004 Jiangxi,China;The Affiliated Reproductive Hospital of Jiangxi University of Chinese Medicine/Nanchang Reproductive Hospital,Nanchang 330001 Jiangxi,China)

机构地区：[1]江西中医药大学,江西南昌330004 [2]江西中医药大学附属生殖医院/南昌市生殖医院,江西南昌330001

出　　处：《广州中医药大学学报》2024年第12期3222-3227,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：江西省中医药管理局科技计划资助项目(编号:2023B0518)。

摘　　要：【目的】观察针刺联合西药治疗子宫内膜异位症(EMs)的临床疗效。【方法】将82例寒凝血瘀型子宫内膜异位症患者随机分为观察组和对照组,每组各41例,对照组给予米非司酮和桂枝茯苓胶囊口服,观察组在对照组治疗的基础上,给予针刺治疗。2组患者均治疗3个月经周期。治疗3个月后,评价2组临床疗效,观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分和焦虑自评量表(SAS)的变化情况,以及中医证候积分的情况。比较2组患者治疗前后血清血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)和前列腺素E2(PGE2)水平的变化情况。【结果】(1)观察组总有效率为92.68%(38/41),对照组为75.61%(31/41)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者VAS评分和SAS评分均明显改善,且观察组在改善VAS评分和SAS评分方面明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者中医证候积分均明显改善,且观察组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者血清VEGF、MMP-9和PGE2水平明显改善,且观察组在改善血清VEGF、MMP-9和PGE2水平方面明显优于对照组,差异均有统计学意义(P<0.05)。【结论】针刺联合西药治疗子宫内膜异位症,可明显改善患者的疼痛症状,缓解患者的焦虑状况,减轻患者的临床症状,并调节患者VEGF、MMP-9和PGE2水平,临床疗效显著。Objective To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of endometriosis(EMs).Methods A total of 82 patients with EMs of cold accumulation causing blood stasis type were randomly divided into observation group and control group,41 patients in each group.Mifepristone and Guizhi Fuling Capsules were oral administration in the control group,and the observation group was treated with acupuncture based on the treatment of the control group.patients in the two groups were all treated for three menstrual cycles.After three months of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Visual Analogue Scale(VAS)and Self-Rating Anxiety Scale(SAS)of pain,as well as traditional Chinese medicine(TCM)syndrome scores before and after treatment were observed.The changes of serum levels of vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)and prostaglandin E2(PGE2)between the two groups before and after treatment were compared.Results(1)The total effective rate was 92.68%(38/41)in the observation group and 75.61%(31/41)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,VAS scores and SAS scores of patients in the two groups were improved significantly,and the improvement in the observation group was significantly superior to that in the control group,and the differences were statistically significant(P<0.05).(3)After treatment,the TCM syndrome scores of the two groups were significantly improved,and the improvement in the observation group was significantly superior to that in the control group,with statistically significant differences(P<0.05).(4)After treatment,the serum levels of VEGF,MMP-9 and PGE2 of the two groups of patients were improved significantly,and the improvement in the observation group was significantly superior to that in the control group,and the difference was statistically sign

关 键 词：针刺 米非司酮片 子宫内膜异位症 寒凝血瘀 血管内皮生长因子 基质金属蛋白酶-9 前列腺素E2 临床疗效 

分 类 号：R246.9[医药卫生—针灸推拿学]